Browsing by Author "Hoffman-Longtin, Krista"

Now showing 1 - 4 of 4
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    Communication Between Registered Nurses and Family Members of Intensive Care Unit Patients
    (AACN, 2022-12-01) Dees, Mandy L.; Carpenter, Janet S.; Hoffman-Longtin, Krista; School of Nursing
    Background Effective communication between intensive care unit patients and their families and nurses promotes relationship-centered care and improves nurses’ ability to meet patient and family needs. However, communication with these patients is challenging because of their critical illness. Families often become surrogate decision makers for adult intensive care unit patients. Objective To systematically assess available evidence on communication between adult intensive care unit patients and their families and nurses as the initial step in developing nursing strategies to strengthen communication skills. Methods In this integrative review, the method of Whittemore and Knafl was used to synthesize findings from qualitative and quantitative (descriptive and experimental) research. Results The review revealed a variety of research designs, measurement tools, and types of interventions. The qualitative findings suggest that nurses can strengthen relationship-centered care by regularly updating patients’ families and providing information that can assist with decision-making. The quantitative findings suggest that nurses should be mindful of family members’ needs for assurance, comfort, and support. Providing information on patient status can help alleviate family concerns. Conclusions Improved communication between patients and families and intensive care unit nurses is essential to strengthen relationship-centered care. Additional research is needed to better understand the communication needs of adult patients and their families in the intensive care unit.
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    Investigation into Tissue-Specific Mechanisms of Mitochondrial Dysfunction: Models of SUCLA2 Deficiency and a Screen for Potential Genetic Modifiers
    (2023-11) Lancaster, Makayla S.; Graham, Brett H.; Kim, Jungsu; Hoffman-Longtin, Krista; White, Kenneth E.
    With no currently effective treatments available, mitochondrial diseases are one of the most common forms of inherited multisystem disease. Primary disorders of the mitochondria affect an estimated 1 in 4,300 people with typical onset in early childhood. Mitochondrial disorders are classically defined by defects in the mitochondrial powerhouse, or respiratory chain (RC). Therefore, they are uniquely complex as the proteins within the RC are encoded by two separate genomes – nuclear DNA (nDNA) and mitochondrial DNA (mtDNA). The mitochondrial genome encodes 13 protein genes within the RC, with the remaining mitochondrial proteome being nuclear encoded. Therefore, mitochondrial disorders result from pathogenic variants within either genome. While mitochondrial disorders can affect multiple tissue symptoms, organs with high energy demand, such as the brain and skeletal muscle, are most typically affected; thus, mitochondrial disease typically manifests as an encephalomyopathy. A wide range of symptoms, including developmental delay, seizures, strokes, and sensorineural hearing loss have been associated with mitochondrial dysfunction. In short, however, investigation into the pathogenic mechanisms of mitochondrial disorders has proven difficult due to the wide clinical and genetic heterogeneity associated with the disorders. Therefore, this project seeks to investigate pathways of mitochondrial dysfunction using two genetic approaches. First, reverse genetics tools are used to generate tissue-specific mouse models of succinyl-CoA synthetase deficiency, which is a known cause of mitochondrial disease in humans. In parallel, forward genetics is used to screen for variation in mitochondrial phenotypes in a genetically diverse population of mice to identify potential genetic modifiers of mitochondrial function and health. Using both forward and reverse genetics approaches, these studies will allow for the investigation into tissue-specific mitochondrial pathogenesis in novel mouse models, as well as broadly characterize tissue-specific mitochondrial function in vivo. Taken together, both genetic approaches are used to broaden understanding of tissue-specific mitochondrial function in health and disease.
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    Patient Preferences Matter: A Qualitative Inquiry With Patients About the Surgical Decision for Osteosarcoma in the Lower Extremity
    (2020-06) Panoch, Janet Elizabeth; Goering, Elizabeth; Parrish-Sprowl, John; Hoffman-Longtin, Krista; Beckman, Emily
    Purpose The experience of surgical patient decision-making for amputation, rotationplasty, or limb salvage surgery for the lower extremity was explored with osteosarcoma survivors and parents. Issues and patient concerns were examined prospectively in Facebook posts and retrospectively in personal interviews. Recommendations were sought for the development of a decision aid. Methods A qualitative inquiry was conducted in two studies: 1) a content analysis of 15 Facebook posts on the Osteosarcoma and Ewing’s Sarcoma Support Group about the surgical decision, and 2) a narrative analysis of 20 interviews with survivors and parents about their lived experience. The interview guide was informed by a knowledge translation theoretical model. In-person or video interviews included 29 parents or adolescent-young adults between the ages of 14-71 across 15 states. Results Participants were concerned about making the best decision for themselves or their child. Having little time to make the decision contributes to feeling overwhelmed and uninformed. The lack of information about options, potential limitations, prosthetic needs, and long-term functional outcomes impacts the decision-making process. Resources for finding information are limited. Shared decision-making approaches were preferred though many decisions were made by the surgeon. Patients felt unprepared for complications encountered after limb salvage. Conclusions Limb salvage surgery remains the gold standard for most providers; participants felt there was a bias on the surgeon’s part for salvage. Potential complications and uncertainties of each option were largely omitted in consultations; information about living with a prosthesis is an unmet need for decision-making. The decision affected their quality of life in ways they did not anticipate, resulting in additional decisions. Implications The findings of this study can be used in medical education for orthopedic surgeons to understand the long-term outcomes of limb salvage surgery. Patient preferences matter in the decision and patients who are involved in the decision are more satisfied if they are prepared for the unknown and potential complications. Recommendations for a decision aid include an online format, content that includes a discussion of uncertainties as well as complications of each option, patient stories for long-term outcomes, and resources for psychosocial support.
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    The Person That Asks the Question Controls the Conversation: College Students' Privacy Management with Physicians about Sexual Behavior
    (2019-09) Hernandez, Rachael; Petronio, Sandra; Bute, Jennifer; Hoffman-Longtin, Krista; Schwartz, Peter
    College students demonstrate a persistent lack of knowledge about safe sexual practices and engage in sexual behavior that puts them at risk for preventable health issues, specifically, sexually transmitted infections and unplanned pregnancy. Fortunately, physicians have an opportunity to provide accurate and timely information about safe sexual behavior to individuals in their care. However, many young people, and in particular young women, are reticent to talk to their physicians about sexual behavior because they typically consider the information to be private. They draw thick privacy boundaries around this information, leading to a missed opportunity to communicate about sexual behavior with their healthcare provider. Exacerbating this issue is the fact that many physicians are also uncomfortable discussing sexual topics with their patients. In this dissertation, Communication Privacy Management (CPM) theory is used to investigate the criteria that female college students employ to negotiate the disclosure and concealment of information about sexual behavior to physicians. Qualitative analysis of open-ended interviews with female college students were used to describe and explain the way college students perceive issues concerning disclosure of sexual behaviors to their physician. These findings have the potential to improve communication interventions both for female college students and healthcare professionals.